Crystal Anthony, MS, LPCC
Individual provider Active NPI Professional Counselor · Sartell, MN
NPI 1629469192 · NPPES record last updated Jun 26, 2024
Key facts
- NPI
- 1629469192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CC00884 (MN)
- Practice address
- 110 14TH Ave E
Sartell, MN 56377-4644 - Phone
- (320) 202-1400
- Fax
- (320) 202-8662
- NPI assigned
- Feb 5, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Core Professional Services, P.a.
Practice addresses (Care Compare)
110 14TH Ave E
Sartell, MN 56377-4644
Phone (320) 202-1400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240716001737 | MN | Practitioner - Mental Health Counselor | 3274076997 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Master of Science - Law
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00884 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Professional Services, P.a. | Current |
Accepting new patients |
Locations
617 Oak St
Brainerd, MN 56401
Phone (218) 829-7140
209 S 2nd St
Ste 300
Mankato, MN 56001
Phone (320) 828-6485
110 14th Ave E
Sartell, MN 56377
Phone (320) 202-1400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CC00884 | MN | Yes |
Addresses
Primary practice location
110 14TH Ave E
Sartell, MN 56377-4644
Mailing address
110 14TH Ave E
Sartell, MN 56377-4644
Phone (320) 202-1400
Other providers in Sartell, MN
- Katelin Anderson
- Marc David Anderson
- Nathaniel Gary Anderson
- Sarah Dianne Anderson
- Roberto K Ang
- Juliana M Arana-Santiago
- Riley Marie Arenkiel
- Heidi Armbrust
- Artistic Smile Dental Center PLLC
- Safaa Asif
All providers in Sartell, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.